Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Facility		$2.00	$2.00	$2.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2.00 / $2.00 / $2.00	Professional		$2.00	$2.00	$2.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $14.13 / $75.86	Professional		$14.13	$14.13	$75.86
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $37.15 / $46.77	Professional		$35.48	$37.15	$46.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $2.00 / $2.00 / $3.39	Facility		$2.00	$2.00	$3.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $31.62 / $52.48	Professional		$29.51	$31.62	$52.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $5.50 / $5.50	Professional		$5.50	$5.50	$5.50
Midlands Facility/Professional Professional Modifier Low / Median / High Price $5.50 / $5.50 / $5.50	Professional		$5.50	$5.50	$5.50
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $31.62 / $52.48	Professional		$29.51	$31.62	$52.48
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $3.63 / $4.57 / $4.57	Professional		$3.63	$4.57	$4.57